Burns' Pediatric Primary Care 8th Edition Test Bank | 20
MCQs per Chapter
Pediatric Primary Care Test Bank & NCLEX-HESI
Review | Burns' 8th Edition
Question 1:
A 4-year-old comes to the clinic for a well-child visit. The nurse
practitioner explains that in primary care they focus on
prevention (e.g., immunizations, anticipatory guidance) and on
managing common acute and chronic conditions. Which
statement best distinguishes “primary prevention” from
“primary care” in pediatric practice?
A. Primary prevention is delivered only in specialty clinics;
primary care is limited to urgent care.
B. Primary prevention refers to actions that prevent disease
before it occurs; primary care is the continuous, comprehensive
care that includes prevention, treatment, and coordination.
C. Primary prevention means treating illnesses early to prevent
complications; primary care only gives vaccines.
D. Primary prevention and primary care are synonymous and
interchangeable terms.
Correct Answer: B
Rationale:
B is correct because primary prevention comprises
,interventions that stop disease before it occurs (e.g.,
immunizations, safety counseling), whereas primary care is a
broader concept — continuous, comprehensive care that
includes preventive services, management of acute and chronic
conditions, developmental surveillance, and coordination of
care. This distinction is foundational in pediatric primary care
practice. A is incorrect because primary prevention is not
limited to specialty clinics and primary care includes more than
urgent care. C is incorrect — treating illnesses early to prevent
complications is secondary prevention, not primary prevention
— and primary care is not limited to vaccines. D is incorrect
because the terms are related but not synonymous; conflating
them would overlook the broader roles of primary care. Elsevier
Health
Question 2:
A 7-year-old's mother frequently cancels appointments because
she lacks transportation and needs tobacco cessation support.
The provider offers to connect the mother with community
resources and screen the child for secondhand smoke exposure.
This approach best exemplifies which pediatric primary care
principle?
A. Disease-focused specialty referral
B. Two-generation (dual patient) approach
C. Episodic treatment of acute issues only
D. Isolated child-centered care without caregiver engagement
,Correct Answer: B
Rationale:
B is correct: the two-generation or dual-patient approach
recognizes that child health is tightly linked to caregiver health
and family context; providers address caregiver needs
(transportation, tobacco cessation) alongside the child’s health
to improve outcomes. A is incorrect — while referrals may be
part of care, the vignette emphasizes addressing caregiver
needs within primary care rather than simply referring to a
specialist. C is incorrect because this example goes beyond
episodic treatment and focuses on prevention and social
determinants. D is incorrect — the scenario explicitly involves
caregiver engagement, which is central to the two-generation
approach.
Question 3:
During a 9-year-old well visit, the nurse practitioner asks a
validated set of questions about household instability, exposure
to violence, and caregiver mental health because the family
history suggests risk. Which best describes why screening for
adverse childhood experiences (ACEs) is important in primary
care?
A. ACEs screening is only useful for research and has no clinical
relevance.
B. Identifying ACEs helps the team recognize exposures that can
increase lifelong risk for behavioral and chronic health problems
, and allows early intervention.
C. ACEs are only associated with childhood illnesses and resolve
by adulthood without long-term effects.
D. Screening for ACEs is contraindicated because it always
causes more harm than benefit.
Correct Answer: B
Rationale:
B is correct: ACEs (abuse, neglect, household dysfunction, etc.)
are linked to increased lifelong risk for mental health disorders,
substance use, chronic disease, and social problems; primary
care screening enables early identification, trauma-informed
approaches, referrals, and mitigation strategies. A is incorrect —
ACEs screening has clear clinical implications for prevention and
care. C is incorrect — ACEs can have long-term, even lifelong,
effects on physical and mental health if unaddressed. D is
incorrect — while screening must be paired with resources and
trauma-informed care (to avoid harm), ACEs screening is not
universally contraindicated. AAP Publications+1
Question 4:
A 17-year-old with type 1 diabetes will graduate high school in 6
months and will need to transfer to adult primary care.
According to best-practice transition planning, which action
should the pediatric provider take now?
A. Discharge the patient immediately and tell them to find an
adult provider on their own.
MCQs per Chapter
Pediatric Primary Care Test Bank & NCLEX-HESI
Review | Burns' 8th Edition
Question 1:
A 4-year-old comes to the clinic for a well-child visit. The nurse
practitioner explains that in primary care they focus on
prevention (e.g., immunizations, anticipatory guidance) and on
managing common acute and chronic conditions. Which
statement best distinguishes “primary prevention” from
“primary care” in pediatric practice?
A. Primary prevention is delivered only in specialty clinics;
primary care is limited to urgent care.
B. Primary prevention refers to actions that prevent disease
before it occurs; primary care is the continuous, comprehensive
care that includes prevention, treatment, and coordination.
C. Primary prevention means treating illnesses early to prevent
complications; primary care only gives vaccines.
D. Primary prevention and primary care are synonymous and
interchangeable terms.
Correct Answer: B
Rationale:
B is correct because primary prevention comprises
,interventions that stop disease before it occurs (e.g.,
immunizations, safety counseling), whereas primary care is a
broader concept — continuous, comprehensive care that
includes preventive services, management of acute and chronic
conditions, developmental surveillance, and coordination of
care. This distinction is foundational in pediatric primary care
practice. A is incorrect because primary prevention is not
limited to specialty clinics and primary care includes more than
urgent care. C is incorrect — treating illnesses early to prevent
complications is secondary prevention, not primary prevention
— and primary care is not limited to vaccines. D is incorrect
because the terms are related but not synonymous; conflating
them would overlook the broader roles of primary care. Elsevier
Health
Question 2:
A 7-year-old's mother frequently cancels appointments because
she lacks transportation and needs tobacco cessation support.
The provider offers to connect the mother with community
resources and screen the child for secondhand smoke exposure.
This approach best exemplifies which pediatric primary care
principle?
A. Disease-focused specialty referral
B. Two-generation (dual patient) approach
C. Episodic treatment of acute issues only
D. Isolated child-centered care without caregiver engagement
,Correct Answer: B
Rationale:
B is correct: the two-generation or dual-patient approach
recognizes that child health is tightly linked to caregiver health
and family context; providers address caregiver needs
(transportation, tobacco cessation) alongside the child’s health
to improve outcomes. A is incorrect — while referrals may be
part of care, the vignette emphasizes addressing caregiver
needs within primary care rather than simply referring to a
specialist. C is incorrect because this example goes beyond
episodic treatment and focuses on prevention and social
determinants. D is incorrect — the scenario explicitly involves
caregiver engagement, which is central to the two-generation
approach.
Question 3:
During a 9-year-old well visit, the nurse practitioner asks a
validated set of questions about household instability, exposure
to violence, and caregiver mental health because the family
history suggests risk. Which best describes why screening for
adverse childhood experiences (ACEs) is important in primary
care?
A. ACEs screening is only useful for research and has no clinical
relevance.
B. Identifying ACEs helps the team recognize exposures that can
increase lifelong risk for behavioral and chronic health problems
, and allows early intervention.
C. ACEs are only associated with childhood illnesses and resolve
by adulthood without long-term effects.
D. Screening for ACEs is contraindicated because it always
causes more harm than benefit.
Correct Answer: B
Rationale:
B is correct: ACEs (abuse, neglect, household dysfunction, etc.)
are linked to increased lifelong risk for mental health disorders,
substance use, chronic disease, and social problems; primary
care screening enables early identification, trauma-informed
approaches, referrals, and mitigation strategies. A is incorrect —
ACEs screening has clear clinical implications for prevention and
care. C is incorrect — ACEs can have long-term, even lifelong,
effects on physical and mental health if unaddressed. D is
incorrect — while screening must be paired with resources and
trauma-informed care (to avoid harm), ACEs screening is not
universally contraindicated. AAP Publications+1
Question 4:
A 17-year-old with type 1 diabetes will graduate high school in 6
months and will need to transfer to adult primary care.
According to best-practice transition planning, which action
should the pediatric provider take now?
A. Discharge the patient immediately and tell them to find an
adult provider on their own.
